PERFORMING LAPAROSCOPIC SURGERY FOR PANCREATIC CANCER: Advancing Minimally Invasive Surgery for Cancer

Pancreatic cancer is a disease with a generally poor prognosis. Delay in onset of symptoms leads to initial diagnoses in more advanced disease. Surgery is the only hope for potential cure, but is only available to patients whose disease has not spread outside of the pancreas. Traditionally, there are two major "open" operations done to remove pancreatic cancers dependent on their location.

Laparoscopic pancreatic cancer resection (tumor removal) is now being championed by a few surgeons, who have the advanced skills to perform it, in order to provide patients with the advantages of the minimally invasive approach, compared with these conventional operations.

In June 2006, Kevin T. Watkins, MD, assistant professor of surgery and director of our Center for Minimally Invasive Surgery, performed the first laparoscopic pancreatic cancer resection at Stony Brook — the first operation of its kind done on Long Island.

The patient was a significant risk for surgery because of numerous co-morbid illnesses. He had his resection performed, and was discharged from the hospital without complication.

This patient has been able to start his systemic chemotherapy, which he is tolerating well. And he has also been able to return to his usual lifestyle.

A national leader in the field of laparoscopic surgery, Dr. Watkins performed his first laparoscopic pancreatic cancer resection in 2002, before any reports of this operation were published in the literature. He is now working to publish his long-term results with this operation.

To date, Dr. Watkins has performed 14 laparoscopic pancreatic resections, four of which were done for cancer. "The numbers are generally low because these are unusual cases," he explains.

Four of these resections were done by Dr. Watkins here at Stony Brook, including a cystic tumor nearly 8 inches in size, since he joined our faculty in 2004. Dr. Watkins also uses the laparoscopic approach to treat diseases of the pancreas other than cancer.

Benefits of Laparoscopic Pancreatic Cancer Surgery

Laparoscopy offers the possibility to improve recovery time and restore normal functional activities more rapidly. Since the life expectancy of patients with pancreatic cancer is usually less than one year, these improvements in recovery should lead to significant increases in quality of life.

In addition, a faster recovery will mean that patients may start other forms of treatment, including chemotherapy, in a more expeditious fashion, compared with conventional surgery.

Moreover, because laparoscopic surgery results in less physiologic stress to the body, these patients may have a better chance of responding to the therapy.

The majority of pancreatic cancers occur in the head of the pancreas. Surgical removal of this area requires an extensive operation that, at this point, is not practical laparoscopically, at least to improve recovery time.

Lesions in the tail of the pancreas are potentially amenable to a laparoscopic approach to resection. Although reports of these operations being performed have been published in the medical literature, no large series with long-term outcome results have yet been reported.

Our efforts at Stony Brook to advance cancer care with the most sophisticated form of laparoscopic surgery reflects our commitment to excellence in patient care.

For consultations/appointments with Dr. Watkins, please call 631-444-4545.